Individual provider Active NPI

Miranda Lou Munday, MD

  • Pediatrics Physician
  • Danville, KY
National Provider Identifier
1083059711
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
48854 Issued in KY
Practice address
303 S 4TH St
Danville, KY 40422-2091
Phone
(859) 236-1080
NPI assigned
May 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R3333 KY
Pediatrics Physician 208000000X 48854 KY Primary

Addresses

Primary practice location

303 S 4TH St
Danville, KY 40422-2091

Mailing address

303 S 4TH St
Danville, KY 40422-2091
Phone (859) 236-1080

Other identifiers 1

IdentifierTypeStateIssuer
7100307540MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150818003973 KY Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 2264747476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
48854KYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Danville Pediatrics Medical Group PLLC Current Accepting new patients
Danville Pediatrics Medical Group PLLC Current Accepting new patients
Ephraim McDowell Regional Medical Center Incorporated Past Accepting new patients

Locations

303 S 4th St
Ste 100
Danville, KY 40422
Phone (502) 331-5478

303 S 4th St
Danville, KY 40422
Phone (859) 236-1080

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Danville Pediatrics Medical Group PLLCDanville, KY, CCN B03884 Rural health clinic 5% Or Greater Direct Ownership Interest (20%) Dec 1, 2021
Lawrenceburg PediatricsLawrenceburg, KY, CCN B03885 Rural health clinic 5% Or Greater Direct Ownership Interest (20%) Dec 1, 2021

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538611200000",
    "number": "1083059711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 S 4TH ST",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404222091",
            "telephone_number": "859-236-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S 4TH ST",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404222091",
            "telephone_number": "859-236-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNDAY",
        "first_name": "MIRANDA",
        "middle_name": "LOU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-08",
        "last_updated": "2018-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "R3333",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "48854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100307540",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, KY

Sources for this page

Verify at the official NPI Registry.